Volume 6, Issue 2, February – 2021 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

The Level of Substance Use Disorders in Tombia

Community, Bayelsa State-Nigeria
1.
Chia Francis
Directorate of Drug Demand Reduction, National Drug Law Enforcement Agency, Nigeria (Corresponding author).
2.
Lawrence Ayah Iruo
Department of Mental Health & Psychiatric Nursing.
Faculty of Nursing, Niger Delta University, Wilberforce Island, Nigeria
3.
Uzzi O. Henry
Directorate of Drug Demand Reduction, National Drug Law Enforcement Agency, Nigeria

Abstract:- This study examined the level of drug use and
substance use disorders in Tombia community of
Bayelsa state. The sample for this study included 189
participants drawn from different sections of Tombia
community. A questionnaire titled Substance Use
Assessment Scale (SUAS) for the Youths in Tombia
community was used for data collection. The result of
the study indicated that use of drugs such as alcohol,
tramadol, cannabis, and diazepam is high in Tombia
community. Among those using drugs, substance
disorders were also very high. It was therefore suggested
that public education on the effects of substance use and
life skill training programs should be intensified among
youths in Tombia community.
Keywords:- Substance Use Disorders, Level, Tombia.
I. INTRODUCTION
Use of alcohol and other psychoactive substances is
associated with serious social and public health problems,
but the extent of the problem in Sub‐Saharan Africa is not
well known (Acuda, 2011). In 2016, the United Nations
Office on Drugs and Crime (UNODC) estimated that 275
million people aged 15–64 used drugs at least
once(UNODC, 2018), and the prevalence of drug use and
drug use disorders has increased significantly in the period
2010–2016(WHO,2018). Thus, substance use disorders has
caused about 20 million disability-adjusted life years
(DALYs) and 8.6 million years of life lost (YLL) across
regions and countries (Whiteford et al, 2013).
In Nigeria, the 2018 national survey on drug use by
means of the different domains of dependence, as given in
the WHO ICD 10 criteria, revealed that 20 per cent of
people who self-reported past year use of any drug (other
than tobacco and alcohol) were considered drug dependent.
More than one third of cannabis users, one quarter of heroin
users, and 20 per cent of those who had misused
pharmaceutical opioids (such as tramadol, codeine,
morphine) in the past twelve months met the criteria of
dependence. Prior to this time, Gureje et al, 2007 in their
study on descriptive epidemiology of substance use and
substance use disorders in Nigeria during the early 21st
century identified high prevalence of common substance
disorders such as failure to fulfil role obligations, legal
problems, and impaired control over use of the drug in
Nigeria. This study is one of the pioneering work that
brought the connection between substance use and substance
use disorders to public knowledge in Nigeria. However,
further studies on this subject matter in local communities
are lacking so young people go about using drugs without
giving thought to the disorders associated with it.
In Tombia community of Bayelsa state- Nigeria,
substance use is such that most of the socio-cultural
activities freely support the consumption of alcohol and
other related psychoactive substances. For example, during
cultural ceremonies such as burial, marriage naming and the
like, local gin laced with marijuana and palm-wine that is
blended with stout beer are freely served and consumed by
the youths (Olalekan, Funmilayo, Iteimowei, Okoyen &
Oyinlola, 2019 and Funmilayo, Robert, Olalekan, Okoyen &
Tuebi, 2019).
A similar study on the context of adolescent substance
use in Yenagoa local government area comprising Tombia
area revealed that majority of the adolescent who use
cigarettes, used it regularly (79.6%) while marijuana
(66.7%) and alcoholic beverages were also taken regularly
by most of the respondents who indicated that they take
these substances. For cocaine, majority of the respondents
take it occasionally. Therefore, cigarettes, marijuana and
alcoholic beverages were taken regularly while cocaine was
taken occasionally.
Available data from the Nigerian Bureau of Statistics
presented by (Adebowale, 2019) revealed that South-South
geo-political zone where Tombia community is located is
the least restrained zone of alcohol consumers in the
country. The report further showed that in 2016 alone,
N74.4 billion was spent on alcohol use in the zone, thus
describing people living in the zone as the most passionate
alcohol users of the year in the country compared to other
zones such as the North West zone, who had the most
controlled alcohol users with an estimated expenditure of
N2.6 billion on alcohol use in the same year. From the data
above, South-South citizens including those of Tombia
community in Bayelsa state seems to be more at risk to

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Volume 6, Issue 2, February – 2021 International Journal of Innovative Science and Research Technology
suffer from alcohol-related health disorders than the rest of
the citizens from other geo-political zones in Nigeria.
The above assertion is predicated on the fact that light
to moderate alcohol consumption is associated with lower
rates of some diseases, such as diabetes mellitus and
coronary heart disease. However, heavy consumption has
been associated with increased rates of chronic diseases,
including cancer; mental, neurological, and substance use
disorders; cardiovascular disease; and liver and pancreas
diseases (Rehm, et al 2010). Alcohol also has been
implicated in the development of depression and personality
disorders, although the direction of causality and the effects
of confounding factors remain uncertain (Rohde et al, 2001).
The growing use of psychoactive substances among
youths in Nigeria with little attention given to the disorders
associated with it has become a serious concern in the
country. This thoughtless attitude is encouraged by the fact
that there are no regular data from epidemiological studies
showing the true picture of the atrociousness of the drug use
situation and substance use disorders associated with it as is
obtainable in other thematic areas of the health care delivery
system (WHO, 2006).
While enormous documented information on disorders
associated with substance use exist in other parts of the
world, data on substance use disorder in Tombia community
of Bayelsa state and other adjoining communities in the geo-
political zone at large is lacking. The implication of this
situation is that, substance use in Tombia community will
hardly be seen as a public health problem and the situation
will never attract any public response. This point of view is
based on the claim by Vos etal, 2010 that historically, major
health policy decisions and response have been informed by
the availability of data on the presenting health problems.
In attempt to address other health problems in Nigeria,
a provision has been made for regular data collection on
such health issues with the exclusion of substance use and
associated disorders. For example, the National Health
Management Information System (NHMIS) in Nigeria
designed a data tool called the NHMIS Monthly Summary
Form for Health Facilities. The form contains different
thematic areas in health care such as maternal health,
nutrition, surgeries, communicable/non-communicable
diseases, family planning, referrals, laboratories services etc
(233 items in all). The form is distributed to all health care
facilities (at the Primary, Secondary and Tertiary levels). At
the Primary Health Care (PHC) level, data from patients in
the community are inputted into the forms at the end of
every month. The completed forms are then sent to the
Monitoring and Evaluation (M&E) officers at the Local
Government Area (LGA) headquarters who then uploads the
data from the NHMIS form into the District Health
Management Information System Version 2 (DHIS2).
In the same manner, data from the General Hospitals
or other secondary health care facilities are inputted into the
MHMIS Monthly Summary Form at the end of every
month. The completed forms are sent to the State Ministry
IJISRT21FEB512 www.ijisrt.com
ISSN No:-2456-2165
of Health where the data are finally uploaded to the DHIS2
database. This same trend is applicable to the tertiary health
care facilities like the teaching hospitals. In the case of
tertiary hospitals, their data is sent directly to the Federal
Ministry of Health where the data is uploaded to the DHIS2
database. All the data from the three levels of health care
delivery systems in Nigeria are then synchronized by the
DHIS2 database (FGN, 2006). According to Vo(2019), the
DHIS2 software is developed for storing, reporting and
analyzing health and health related data.
DHIS2 database reviews, updates and upgrades data in
different geographical areas on a monthly basis on specified
health issues. The situation where substance use and mental
health are not captured by the NHMIS Monthly Summary
Forms for health facilities nor the DHIS2 database explains
why current data on substance use disorders is lacking in the
Bayelsa state and the country in general. When one is
looking for information on substance use and disorder in
Bayelsa state, it becomes an uneasy task as such information
are hardly available. Where they are found at last, they are
stale due to lapse of time. For example, one of the current
accessible source of information on substance use in
Bayelsa state is the UNODC (2018) National Household
Survey. The survey placed Bayelsa at 14% annual
prevalence rate of substance use; one of the highest in
Nigeria. But presently, the above data may be stale because
of time lapse.
Zaccheaus & Iruo (2020) and Abikoye (2015)
observed a poor documentation of substance use disorders in
the Niger Delta region (including Bayelsa state), hence
inferences of the seriousness of the problems are simply
being inferred from the rising incidence of rape, youth
restiveness, cultism and other criminal tendencies of the
adolescent in and around the state. EMCDDA (2019) noted
however that without systematic and up-to-date
epidemiological data and indices on substance use disorders,
it becomes difficult, if not impossible to conduct a need
analysis for proper planning and designing an effective
substance use intervention response. This claim is what
prompted the need for this study in order to make data on
the level of substance disorders in Tombia community of
Bayelsa state available to the public. This is essential for
advocacy, further research, planning and implementation of
effective substance use interventions in the region and the
country at large.
II. METHOD
 Participants
A total of one hundred and eighty nine (189) youths
(Male=115 Female=74, aged 14-35 years) residing in
Tombia community participated in the study. The
instrument used for data collection was Substance Use
Assessment Scale (SUAS) for the Youths in Tombia
developed by the researchers. The researchers secured
permission from the representative of the Amananaowei of
the community. The services of five research assistants
(RAs) were engaged from the youth body. The RAs were
mentored on how to recruit respondents. They were to put
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on face mask and to tell the respondents that participation in
the exercise was voluntary and that their responses will be
treated with utmost confidentiality.
III. RESULT
Table 1: Level of drug use in Tombia community
1 Drug users 71(37.56%)
2 Non-drug users 118(62.43%)
Total 189
Table 1 showed that, 71(37.56%) of the participants
agreed that they had used psychoactive substances in the
past 30 days while 118(62.43%) declined using
psychoactive substances in the past 30 days.
Table 2: Level of substance use disorders among drug
users in Tombia community.
1 People using drugs & 59(83.09%)
experiencing substance use
disorders
2 People using drugs but not 12(16.90%)
experiencing substance use
disorders
Table 2 showed that 59(83.09%) participants who
agreed to use of psychoactive substances in the past 30 days
were experiencing substance use disorders. 12(16.90%)
participants who agreed to using psychoactive substances in
the past 30 days were not experiencing substance use
disorders.
Table 3: Common substance use disorders identified
among youths in Tombia community
Substance use disorder No. % V.
1 I want to stop the drugs, but I can't 59 83.09
2 I presently take higher doses than 59 83.09
before
3 It is making me to spend more money 59 83.09
than before
4 It is affecting my productivity in 59 83.09
school/work
5 It has affected my relationship with 55 77.46
other people
Table 3 showed that all the participants who agreed to
using drugs were experiencing substance use disorders such
as: inability to stop using drugs (83.09 %), tolerance
(83.09%), spending more money than before (83.09%), and
reduced productivity at work (83.09%). Worsening
interpersonal relation was however experienced by
55(77.46%) participants.
IV. DISCUSSION
The study found a high level of drug use among the
youth population studied in Tombia community of Bayelsa
state. Drugs commonly available include alcohol, cannabis,
diazepam, and tramadol. This is supported by the study
findings of Funmilayo et al, 2019. The result of their study
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International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
among adolescents in Yenagoa Bayelsa state revealed that
majority of the adolescent who use cigarettes, used it
regularly (79.6%) while marijuana (66.7%) and alcoholic
beverages were also taken regularly by most of the
respondents who indicated that they take these substances.
For cocaine, majority of the respondents take it
occasionally.
The study also found high level of substance use
disorders among drug users. For example, among a total of
71 participants that agreed to using drugs, 59 of them were
experiencing substance use disorders while only 12 of those
using drugs denied experiencing substance use disorders.
The result of this study support the findings of the national
survey on drug use, 2018. Result of the 2018 national survey
revealed that 20 per cent of people who self-reported past
year use of any drug (other than tobacco and alcohol) were
considered drug dependent. More than one third of cannabis
users, one quarter of heroin users, and 20 per cent of those
who had misused pharmaceutical opioids (such as tramadol,
codeine, morphine) in the past twelve months met the
criteria of dependence.
Among the substance use disorders found among
youths in Tombia community, disorders such as: I want to
stop the drugs, but I can't., I presently take higher doses than
before., It is making me to spend more money than before.,
It is affecting my productivity in school/work, top the list.
This was followed by participants battling with poor inter
personal relationship. This finding is consistent with Gureje
et al, 2007 who identified high prevalence of common
substance disorders such as failure to fulfil role obligations,
legal problems, and impaired control over use of the drug.
LIMITATION OF THE STUDY
The participants for this study were youths from
Tombia community of Bayelsa state. The sample size of 189
youths out of thousand other youths in the community is
quite small. The choice of this small sample size was
however guided by the resources at hand. The size of youths
that participated in this study cannot therefore be a
representation of the entire youths in the community and
Nigeria at large. The generalization of this study is therefore
limited.
VI. CONCLUSION
This study is one of the first attempts to examine the
prevalence of substance use disorders in South-South region
of Nigeria and Tombia community in particular. The study
revealed a high use of drugs in Tombia community among
youths. The study also revealed that among those using
drugs, reported substance use disorders were very high. In
view of the above, the following recommendations are
made:
a) Public education on the effects of substance use and life
skill training is essential for youths in Tombia community.
This is to drive away ignorance on consequences of
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substance use as well as to give youths talents to handle
drug offers in their community.
b) Efforts should also be made to see that substance use and
associated disorders is included in the National Health
Management Information System (NHMIS) which collect
data monthly on certain thematic areas in health care in the
country. This data/information will be useful for advocacy,
policy and program design.
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